RESUMEN
INTRODUCTION: Reducing the Length Of postpartum Stay (LOS) is associated with lower hospital costs, a major reason for initiating federal projects in Belgium. Disadvantages following the reduction of LOS are the risks of maternal and neonatal readmissions. This study compares readmissions with or without reduced LOS, by introducing the KOZI&Home program in the university hospital Brussels. METHODS: This is an observational study comparing the readmission rates of the length of postpartum hospital stay between two groups: the non-KOZI&Home group (> 2 days for vaginal birth and > 4 days for caesarean section) and KOZI&Home group (≤ 2 days for vaginal birth and ≤ 4 days for caesarean section). A follow-up period of 16 weeks was set up. RESULTS: The maternal readmission rate was 4,8% for the non-KOZI&Home group (n = 332) and 3.3% for the KOZI&Home group (n = 253). Neonatal readmission rates were 7.2% and 15.9% respectively. After controlling influencing factors in a multivariate model for maternal and neonatal readmissions, there were no statistical significant differences. Factors negatively affecting neonatal readmissions are (1) dismissal period October-January (OR:3.22;95% CI 1.10-9.42) and (2) low education level (OR:3.44;95% CI 1.54-7.67), for maternal readmissions it concerns whether or not LOS is known (OR:3.26;95% CI 1.21-8.81). DISCUSSION: There is no effect of the KOZI&Home program on maternal nor neonatal readmission rates. Systematically informing about postpartum LOS antenatally will enforce preparation and is important to reduce maternal readmissions. Personalized information should be given to women discharged in the period October-January and to those with a lower education level, in order to reduce neonatal readmissions.
What is already known on this subject? Reducing the 'length of stay' after giving birth is known, for example, to reduce costs and for having a more family-centered approach. Above the known advantages, there is also some conflicting literature about the disadvantages. Some of the articles shown a higer readmission rate, and others no difference in readmission rates.What this study adds? The influencing factors of maternal and neonatal readmissions are checked, in order to reduce the number of readmissions in the future. Systematically informing about postpartum LOS antenatally will enforce preparation and is important to reduce maternal readmissions. Personalized information should be given to women discharged in the period October-January and to those with a lower education level, in order to reduce neonatal readmissions.